Health Division: Bureau of Health Care Quality and Compliance

Transcription

1 Beatty Low-Level Radiation Storage Facility Files 01/11/2006 This records series documents the licensing, monitoring and closure of the Beatyy Low Level Radioactive Storage Facility of U.S. Ecology, Inc., by the Health Division. The files may contain, but are not limited to: License application with associated documentation; Proposed license conditions; Facility standards manual; Site stabilization and closure plan; Financial documentation; Site user violations documentation including any legal documentation; GAO report, environmental monitoring reports, surveys, groundwater monitoring reports, etc.; Evaluations; Site inspections; Related correspondence. Retain these records for a period of ten (10) calendar years after the closure of the facility Child Care Facility License Applications - Denied This record series documents the application process for licenses which have been denied in accordance with NRS 432A.190. The files may include, but are not limited to: Application with associated documentation including educational transcripts; Criminal background information and investigation documentation (NRS 432A.170 to 432A.175); Related correspondence. Retain these records for a period of seven (7) calendar years from the date of denial or final action in the case Child Care Facility License Applications - Incomplete or Withdrawn This record series documents the application process for licenses in accordance with NRS 432A.141that were withdrawn or otherwise incomplete. The files may include, but are not limited to: Application with associated documentation including educational transcripts; Criminal background information and investigation documentation (NRS 432A.170 to 432A.175); Related correspondence. Retain these records for a period of one (1) calendar year from the date withdrawn or from the expiration of the validity period of the application Child Care Facility License Applications Complaint Files This record series documents complaints and investigations concerning facilities in accordance with NRS 432A.190 to 432A.220 and NAC 432A.230. The files may contain, but are not limited to: Complaint documentation; Investigation reports with supporting documentation; Related correspondence. Retain these records for a period of three (3) calendar years from the close of the case Child Care Facility License Files This record series documents the monitoring of individuals licensed to operate a faculty (Director's Files) in accordance with NRS 432A.141 to 432A.220 and NAC chapter 432A. The files may contain, but are not limited to: Applications with associated documents; Description of the facility (NRS 432A.150); Investigation reports; Inspection reports (from the Bureau, State Health Officer and/or State Fire Marshall); Training approvals; Current employee clearance letters; Requests for waivers; Related correspondence. Retain these records for a period of six (6) calendar years from the end of the calendar year to which it pertains Child Care Facility License Files: Background Information Page 1 of 9

2 This record series documents the background investigation of all applicants, licensees and employees of facilities in accordance with NRS 432A.170 to 432A.175 and NAC 432A.200 (2) through (4). The files may contain, but are not limited to: Criminal history reports; Written statement of criminal conviction; Bureau investigation reports (See NAC 432A.200 (2)); Documentation of waiver requests; Related correspondence. Retain these records for a period of six (6) calendar years from the date received CLIA Federal Database 07/14/2004 This electronic records series is used in the administration of the certification, survey and compliance monitoring functions, and federal reporting requirements, concerning medical laboratories. These databases are maintained by the Centers for Medicare and Medicaid Services (CMS). These databases include: CLIA (Clinical Laboratories Improvement Amendments), Oscar (Online Survey Certification and Reporting System) and Odie (Online Data Input and Edit). Data may include information from "Medicare/Medicaid Certification and Transmittal" form, Request for Certification form, "Statement of Deficiencies and Plan of Correction" form, "Crucial Data Extract" (CDE), "Post-Certification Revisit Report" and other data. Update this database as needed, retaining data for a period of three (3) calendar years from the end of the calendar year to which they pertain CLIA Federal Lab Certification Files 07/14/2004 This records series is used in the administration of the certification, survey and compliance monitoring functions concerning medical laboratories in accordance with 42 U.S.C. 263a "Clinical Laboratories Improvement Act" [also known as "Clinical Laboratories Improvement Amendments"], 42 CFR Part 488 and 42 CFR Part 493. The files may include, but are not limited to: Application with associated documentation; "Medicare/Medicaid Certification Transmittal" form; "Clinical Lab Survey Report" form; "SOD/POC or Revisit Report" (Statement of Deficiency and Plan of Corrective Action); "Survey Team Composition & Workload Report"; "Ownership Disclosure"; "Lab Personnel Report"; Estimated test volume; Blood Bank Inspection Checklist; CLIA Certificate; Proficiency Testing Enrollment Confirmation; Related correspondence. Retain this record series for a period of four (4) calendar years from the end of the calendar year to which they pertain CLIA Federal Lab Certification Files: Adverse Actions This records series is used in documenting adverse actions (such as reprimands, censure, probation, suspensions or revocations) concerning medical laboratories in accordance with 42 U.S.C. 1396r-2 "Information concerning sanctions taken by State licensing authorities against health care practitioners and providers." The files may include, but are not limited to: Investigative reports with supportive documentation; Hearing documents (notification of hearing, minutes of hearings, etc.); CMS (Centers for Medicare and Medicaid Services) reports & documents; Related correspondence Complaint Files: Medical Labs This record series documents the processing of complaints against a Medicare, Medicaid or CLIA (Clinical Laboratories Improvement Amendments) participating program received pursuant to NRS (2), 42 U.S.C. 1396r-2 and the Centers for Medicare and Medicaid Services (CMS) State Operating Manual (SOM) Chapter 5. The files may contain, but are not limited to: Complaints and supportive records; Investigation documents; Statement of deficiencies, certification of noncompliance, plan of correction, etc.; Related correspondence. Retain these records for a period of four (4) years from the end of the date the complaint was "closed" and a copy of all required documentation placed in the Facility Certification file. See Centers for Medicare & Medicaid Page 2 of 9

3 Services (CMS) State Operations Manual (SOM) Chapter 5, Section "Resolution/Closeout." Drug and Cosmetic Manufacturing Licensure Files This records series consists of the licensing files for the manufacture of drugs and cosmetics in accordance with NRS Chapter 585 and NAC through.840. The files may contain, but are not limited to: Application material; Inspection reports; Confidential information regarding the product to be produced, plans, description of processes, testing results, etc.; Official notices; Complaints, hearings and disciplinary actions; Related correspondence. Retain these records for a period of three (3) calendar years from the expiration or close of the license Engineering Plan Reviews This records series is used to review plans for compliance with public health laws in accordance with NRS 439A.100. The files may include, but are not limited to: Blueprints, plans, maps, etc.; Public notices; Letters of approval or denial; Complaints & investigation reports; Copies of construction and occupancy permits; Equipment standards; Fee documents; Hearing documentation; Related correspondence. Retain these records for a period of ten (10) calendar years from date of the substantial completion of the project Facilities Designations Files This records series is a sub file of the State Licensing files (through licensing, a facility may be "designated" as an acute care facility for example), and is used to hold the supporting documentation to licensing applications provided by the applicant. The files may contain, but is not limited to, documents that give details on: Equipment (type, location, specifications, etc.); Medical staff (technicians, professionals, MD's, etc.); Staffing plan (lists of staff available per shift, alternate and emergency staffing plan, etc.); Facility policy and procedures (for training, emergencies, power loss, fire, security, etc.). Retain these records for a period of six (6) calendar years from the end of the calendar year to which they pertain Facilities Federal Survey Files This records series is a sub file of the Certification Files and is used to document the surveys (investigation type proceedings) for initial certification, recertification and compliance monitoring for facilities who participate in the Federal Medicaid and/or Medicare Programs as described in 42 U.S.C. 1395aa and 1395bb (see also 42 CFR Part 488). The files may consist of, but are not limited to: Federal HCFA (Health Care Financing Agency) forms (including "Hospital Request for Certification" and "Health Insurance Benefit Agreement"); Health insurance letter; SOD/POC (statement of deficiencies and plan of corrections) documents; Workload data sheet; Medical file reviews; Related correspondence. Retain these records for a period of six (6) calendar years from the end of the calendar year to which they pertain Facilities Licensing Database 06/09/2004 This electronic records series is used in the administration of the health care licensing process. The data may contain, but is not limited to information on: The facility; The license (type, license number, owner, licensing/renewal dates, expiration dates, etc.); Administrator(s); Payments; Renewals; And a note field on what the facility is licensed to do. Page 3 of 9

4 Update this database as needed, retaining data either on-line or on off-line media for a period of one (1) calendar year from the calendar year to which they pertain Facilities Licensing Files 06/09/2004 This records series is used to document the state licensure of health care facilities as described in NRS Chapter 449 and NAC Chapter 449. The files may include, but are not limited to: Licensing documentation; Application Document Checklist with associated records; Plan Reviews; Articles of Incorporation; Disciplinary Actions and complaints with related documentation; Variances with supportive documentation; The files may also include an index and list of where the records of clients from closed facilities have been transferred to or are otherwise maintained. Retain the original application(s) and the last complete six years of documents within the files for a period of six (6) calendar years from the end of the calendar year in which the facility was closed or the license was not renewed, was revoked, was suspended or the file otherwise closed Facilities Licensing Files: Adverse Actions This records series is used to document adverse actions (such as suspensions or revocations) of health care facilities as described in NRS Chapter 449 and NAC Chapter 449. The files may include, but are not limited to: Complaints, investigative reports and compliance survey reports (see NRS to and NAC to ); Copies of hearing records, appeals, decision documents (including any dismissals, conditions, stipulations, etc.); Related correspondence Facilities Medicaid/Medicare Certification Files 06/09/2004 This records series is used to document the certification process for facilities who participate in the Federal Medicaid and/or Medicare Programs as described in 42 U.S.C. Section 1395aa and 1395bb (see also 42 CFR Part 488). The files may consist of, but are not limited to, the following sections: Certification and Transmittal: Federal Centers for Medicare and Medicaid Services (CMS) application and certification forms on initial certification and renewals; Disclosure of Ownership: Federal CMS forms containing information on legal ownership of the facility with supportive documentation; Correspondence: correspondence related to the certification process; Agreements: original signed agreements between the provider and CMS with related forms; Ownership: forms and supportive documents containing information on providers, partnerships, owners, etc.; Disciplinary Actions: containing copies of state compliance survey reports, CMS determinations, hearing documentation, appeals and related documents; Related correspondence. Retain the last complete six (6) years of documents within the files for a period of six (6) calendar years from the end of the calendar year in which the certification was not renewed, revoked, suspended or the file otherwise closed Facilities Medicaid/Medicare Certification Files: Adverse Actions This records series is used to document adverse actions (such as reprimand, censure, probation, suspension or revocation) for facilities who participate in the Federal Medicaid and/or Medicare Programs. The files may consist of, but are not limited to: Copies of documents described in 42 U.S.C. 1396r-2; Copies of state compliance survey reports, CMS determinations; Hearing and appeal and supportive documentation; Related correspondence. Page 4 of 9

5 Facilities State Survey Files This records series is a sub file of the State Licensure Files and is used to document the surveys (investigation type procedure) that is done for initial, renewal or compliance monitoring for state licensure of health care facilities as described in NRS Chapter 449 and NAC Chapter 449. The files may consist of, but are not limited to: Licensure Survey Packet Checklist; Licensure authorization form; Copy of application with supportive documentation; Copy of State Fire Marshall's approval letter; Copy of certificate of insurance; Field notes (which may include photos, copies of facility documents, actual notes and similar documents); Survey booklet (includes facility personnel and resident record checklist), SOD/POC (statement of deficiencies and plan of correction); Resident and personnel rosters (staff lists); Related correspondence. Retain these records for a period of six (6) calendar years from the end of the calendar year to which they pertain Health Protection Complaint Files This records series documents complaints made to the division regarding food-borne illness, trash nuisances, sewage problems, food or product complaints, food establishments, conditions, and other complaints. The record may include, but is not limited to: Complaintant's name and contact information; Description of the complaint; Investigation and action taken; Related correspondence. Retain these records for a period of three (3) calendar years from date of entry Health Protection Permit Files 10/11/2006 This records series consists of the permits issued by the Bureau including, but not limited to: food establishments (including bakeries, public schools, airline food service providers, etc.) in accordance with NRS and NAC to , public spas in accordance with NRS and NAC , public bathing facilities in accordance with NRS and NAC , septic tank pumping contractors in accordance with NAC and individual sewage systems in accordance with NAC to The files may include, but are not limited to: Application material including renewals and copies of permits; Inspection reports; Complaints, hearing documentation, and other disciplinary action documentation; Related correspondence. Retain these records for a period of six (6) calendar years from the expiration of the permit Health Protection Temporary Permit Files This records series consists of permits and certificates issued to applicants on a temporary basis for such events as fairs, special events and similar occasions. The file may contain, but is not limited to: Application material; Fee documentation; Inspection reports; Related correspondence. Retain these records for a period of three (3) calendar years from final date of event Ionizing Radioactive Material License Files 01/11/2006 This records series documents the general and specific classes of licenses for the receipt, possession, use, transfer, owning or acquiring of radioactive material in accordance with the Rocky Mountain Low Level Radioactive Waste Compact (NRS to ), NRS to and NAC to The files may contain: applications, renewals, copies of licenses, amendments, modifications, reciprocal recognition of licenses, revocation & suspensions, administrative actions, judicial actions, inspection reports, related correspondence and similar documentation. Retain these records for a period of five (5) calendar years from the date of expiration, revocation or Page 5 of 9

6 nonrenewal of the license ISDS (individual Sewage Disposal Systems) Residential Files: Approved 10/08/2008 These records are used to review plans for the construction or remolding (improvement) of individual residency sewage disposal systems as required by NRS and NAC to The record may contain but is not limited to: Application; Plans and specifications; Test reports; Project reviews; Related correspondence; Similar documents. Retain these records for a period of forty (40) calendar years from the end of the calendar year in which the permit was approved Lab Personnel Certification and Licensure Files: Adverse Actions This records series is used in the administration adverse actions (including: reprimands, censures, probations, suspension and revocations) concerning the certification of lab personnel and licensure of lab directors in accordance with NRS Chapter 652 and NAC Chapter 652. The files may contain, but are not limited to: Copies of documents from the certification & licensure files; Investigative reports; Dismissal and/or closure proceedings (including negative action or finding, conditions, stipulations, length of time, etc.) with supportive documentation; Related correspondence Low Level Waste Inspection Files This record series contains inspection reports and test results of radioactive waste, the premises, equipment, operations and facilities in which radioactive wastes are received, handled, stored and disposed of pursuant to NAC and Low Level Waste License Files This record series contains information necessary for the issuance of a license for: (1) disposal in soil of radioactive waste (NRS , (1)(a), and ; and NAC to ) and (2) disposal of waste in a State-owned area (NAC to ). Files may contain, but are not limited to: Applications with associated documentation including copies of permits and renewals; Environmental data; Financial information; Audit and inspection reports; Disciplinary actions including investigations, suspensions, revocations and reinstatement; Amendment to terminate; Related correspondence Low Level Waste: Reports by Disposal Site Licensee This record series contains the reports submitted for the disposal site near Beatty pursuant to NAC through Nuclear Regulatory Commission State Agreement File Page 6 of 9

7 This records series consists of agreements with the Federal Government, interstate agencies or any other state committing this state to perform on a cooperative basis inspections or other functions relating to the control of sources of ionizing radiation (See NRS (1)). Retain these records for a period of six (6) calendar years after expiration OASIS / Aspen Databases 06/09/2004 This electronic records series is used in the administration of the certification, survey and compliance monitoring functions required by 42 U.S.C. 1395aa, 42 U.S.C. 1395bb and 42 CFR Part 488. Data may include, but is not limited to: Record formats; Validation edits; Agency encoding and transmission methods; Patient identifiable information; Survey and compliance monitoring information. Update this database as needed, retaining data either on-line or on off-line media for a period of six (6) calendar years from the end of the calendar year to which they pertain Out-of-School Receation Program Permit Files 10/19/2011 These records document the Out-of-School Recreation Program Permit issued to local governments (See AB 362, 2011 Legislative Session and NRS Chapter 432A). The record may consist of, but is not limited to: Applications with supportive documentation; Fee records; Inspection reports; Related correspondence. Retain these records for a period of three (3) calendar years from the expiration of the permit Pools and Spas Files 08/13/2003 This records series is used to review plans for the construction or remolding (improvement) of pools, spas, "water attractions," and similar public bathing related structures as authorized by NRS (NRS to ) and NAC to that are within their jurisdiction (some county health departments have this responsibility). The files may include, but are not limited to: Applications with associated documentation; Plans, manufacture specifications (equipment and outfits), technical documents (equipment and outfits), etc.; Letter of approval or denial; Related correspondence. Retain these records for three (3) calendar years from the end of the calendar year in which the permit was approved or denied and not renewed Radiation Film Badge Records This record series contains the film badge reports showing radiation exposure of all individuals for which personnel monitoring is required (NRS ) Radiation Incident Files This record series contains reports of overexposure and/or excessive levels or concentrations (NAC ). The files may include, but are not limited to: Notification of incidents (NRS and NAC ); Reports of theft, loss of sources of radiation (NAC ). Page 7 of 9

8 Radiation Machine Registration Files This records series constrains the file of registrants possessing sources of ionizing radiation which require registration under the provisions of NRS through , including a record of any administrative or judicial action to such registrants (See NRS (4)(b)). Retain these records for a period of three (3) calendar years after expiration Radiological Emergency Response Plan and Procedures Files This record series contains the emergency response plan and procedures for the division. This plan is part of the Nevada State Hazardous Materials Operations Support Plan which addresses all hazardous materials accidents. These plans are also part of the Nevada State Emergency Plan. (See NRS ). Retain these records for a period of six (6) calendar years after the plan and/or procedures are superseded State Lab Personnel Certification and Licensure Files 07/14/2004 This records series is used in the administration of the certification of lab personnel and licensure of lab directors in accordance with NRS Chapter 652 and NAC Chapter 652. The files may contain, but are not limited to: "Certification," including record of certification/license issued, original application, renewals and acknowledgements; "Evidence," which includes all supportive documentation (including academic transcripts, copies of certificates of registration, proof of employment, letters from employers, and other documentation as described in NAC or ); "Fees," including invoices, receipts and other accounting type documents; "Hearings," including all documentation relating to disciplinary actions and hearings; "Legal," including all documentation related to child support actions or other legal matters (court records, DA documents, etc.); Related correspondence. Retain documents within this record series for a period of six (6) calendar years from the end of the calendar year to which they pertain (three complete certification/licensing cycles) State Medical Lab Certification Files 07/14/2004 This records series is used in the administration of the certification of medical labs in accordance with NRS Chapter 652 and NAC Chapter 652. The files may contain, but are not limited to: Laboratory Packet Coversheet; Application and renewals with associated records; Certification history; Statement of Deficiencies and Plan of Correction (SOD/POC) with supportive documentation; Related correspondence. Retain documents within this record series for a period of six (6) calendar years from the end of the calendar year to which they pertain (three complete certification/licensing cycles) State Medical Lab Certification Files: Adverse Actions This records series is used in the administration of adverse actions (such as suspensions or revocations) of medical labs in accordance with NRS Chapter 652 and NAC Chapter 652. The files may contain, but are not limited to: Copies of documents in the State Certification file; Investigative reports; Dismissal or closure documents (including any negative findings, conditions, stipulations, length of time, etc.); Hearing documents with supportive documentation; Related correspondence. Page 8 of 9

9 Truck Wrecks File 01/11/2012 This records series consists of reports of truck wrecks involving food and/or drugs. The files may contain, but are not limited to: Sanitarian's inspection of the load; Condemnation report; Decision not to condemn the load; Related correspondence. Retain these records for a period of three (3) calendar years from date of report. Page 9 of 9